Effects of COVID-19 on home visiting services for vulnerable families: A cross-state analysis of enrollment, engagement, and attrition patterns.

Abstract

Introduction: COVID-19 has resulted in massive health and economic consequences, with effects felt most acutely by populations that were disadvantaged prior to the pandemic. For families with young children, the effects have been compounded by service interruptions, though there is a lack of empirical evidence that demonstrates how COVID-19 has affected home visiting programs. This cross-state study is the first to examine the effects of the pandemic on home visiting enrollment, engagement, and retention patterns. Method: Program implementation records gathered from 2017-2020 in Arkansas and Wisconsin were analyzed. Both states operate a large network of home visiting programs that serve predominantly lowincome families and that are supported by the federal Maternal, Infant, and Early Childhood Home Visiting program. Trends prior to COVID were compared to post-COVID trends (March 12 to December 31, 2020) in program enrollments, service capacity, visitation frequency, service modalities, attrition rates, and service duration. Results: Compared to average pre-pandemic enrollments from 2017-2019, post-COVID enrollments decreased by 33-36%. Total visits fell by 15-24%; the percentage of completed visits relative to expected visits declined more modestly. However, the average duration of services increased post-COVID while rates of early program dropout decreased. Discussion: The findings suggest that enrollment and engagement in home visiting decreased during the COVID-19 pandemic, which is unfortunate given the large number of vulnerable families served nationwide. Further research is needed to examine how COVID affected both consumer and program behaviors.

Caring for Children With Medical Complexity in the Early COVID-19 Pandemic in an Ambulatory Primary Care Setting

“…Many parents of this medically complex patient cohort reported removing their children from in-person school environments or not allowing in-home care providers (i.e., care managers, therapists, nurses) into the home during that period in order to limit potential exposures. This is reflected in published data that showed a decrease of enrollment in home visiting services by 33–36% during the COVID pandemic ( 14 ). For CMC, the likelihood of COVID-19 exposure early in the pandemic reflected trends in the general population, most notably higher exposure risk in non-White racial groups, though not statistically significant in our analysis.…”

Caring for community members during the COVID-19 pandemic: results of a statewide survey

“…In addition, home visiting programs rapidly adapted their models and service delivery in the onset of the COVID-19 pandemic (Williams et al 2021 ). Multiple studies of home visiting programs around the United States have demonstrated how HVs were able to continue to serve families throughout the COVID-19 pandemic (Rybińska et al 2022 ; Marshall et al 2020 ; Traube et al 2022 ; Roben et al 2022 ), with a couple studies finding a slight decline in program participation (Rybińska et al 2022 ; Mersky et al 2021 ).…”